COVID-19 Testing Among US Children, Parental Preferences for Testing Venues, and Acceptability of School-Based Testing

  1. Chloe A. Teasdale
  2. Luisa N. Borrell
  3. Yanhan Shen
  4. Spencer Kimball
  5. Michael L. Rinke
  6. Madhura S. Rane
  7. Sarah Kulkarni
  8. Sasha A. Fleary
  9. Denis Nash

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Abstract

Testing remains critical for identifying pediatric cases of COVID-19 and as a public health intervention to contain infections. We surveyed US parents to measure the proportion of children tested for COVID-19 since the start of the pandemic, preferred testing venues for children, and acceptability of school-based COVID-19 testing.

Methods:

We conducted an online survey of 2074 US parents of children aged ≤12 years in March 2021. We applied survey weights to generate national estimates, and we used Rao–Scott adjusted Pearson χ 2 tests to compare incidence by selected sociodemographic characteristics. We used Poisson regression models with robust SEs to estimate adjusted risk ratios (aRRs) of pediatric testing.

Results:

Among US parents, 35.9% reported their youngest child had ever been tested for COVID-19. Parents who were female versus male (aRR = 0.69; 95% CI, 0.60-0.79), Asian versus non-Hispanic White (aRR = 0.58; 95% CI, 0.39-0.87), and from the Midwest versus the Northeast (aRR = 0.76; 95% CI, 0.63-0.91) were less likely to report testing of a child. Children who had health insurance versus no health insurance (aRR = 1.38; 95% CI, 1.05-1.81), were attending in-person school/daycare versus not attending (aRR = 1.67; 95% CI, 1.43-1.95), and were from households with annual household income ≥$100 000 versus income <$50 000-$99 999 (aRR = 1.19; 95% CI, 1.02-1.40) were more likely to have tested for COVID-19. Half of parents (52.7%) reported the pediatrician’s office as the most preferred testing venue, and 50.6% said they would allow their youngest child to be tested for COVID-19 at school/daycare if required.

Conclusions:

Greater efforts are needed to ensure access to COVID-19 testing for US children, including those without health insurance.

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  1. Version published to 10.1177/00333549211065518
  2. ScreenIT

    SciScore for 10.1101/2021.05.27.21257932: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsIRB: The institutional review board of the CUNY Graduate School of Public Health and Health Policy provided ethical approval.
    Sex as a biological variablenot detected.
    RandomizationOutcomes were: proportion of parents reporting child tested for COVID-19 (“has your child ever been tested for COVID-19”); where parents would take child for testing (“if your child needs testing for COVID-19 in the future, where would you take him/her to be tested”) including multiple response options; and acceptance of school-based testing (“if your child’s school or daycare required COVID-19 testing on a random basis, would you allow your child to be tested at school or daycare”).
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    There are several limitations to our analysis. Our survey focused on children ≤12 years of age in order to collect information about younger children and does not provide information about adolescents. Survey data were self-reported and subject to recall, response and social desirability bias. The survey was weighted to reflect the US population of parents based on 2019 census estimates. However, it was conducted online, and therefore, excluded parents without access to the internet. Our study provides important information about children who have been tested for COVID-19 thus far in the epidemic and those who may be missed for testing. It also includes novel information about venues where parents prefer to seek testing for their children. Given that a COVID-19 vaccine for children may not be approved for pediatric population until late in 2021(9), and that COVID-19 vaccine hesitancy among parents may be significant(10), testing will remain critical for identifying children with infection and as a public health intervention to contain infections. As such, our data can inform strategies to increase testing coverage and acceptability among US children.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.05.27.21257932v1 on medRxiv